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Biomedical subjects

M K Jensen

Publications and source records attributed to M K Jensen.

At least 55 records · Page 3Linked to original sources
PubMed1993

Continuous subcutaneous infusion of morphine--an alternative to extradural morphine for postoperative pain relief.

In a randomized, double-blind study of 40 patients undergoing total abdominal hysterectomy, we have compared continuous subcutaneous infusion (CSCI) of morphine with discontinuous extradural injection of morphine for postoperative analgesia at rest and during cough. The CSCI group received a bolus of morphine 0.1 mg kg-1 i.v. at the end of the operation and continued with s.c. infusion of morphine 30 micrograms kg-1 h-1. The extradural group received morphine 4 mg extradurally at 0, 2, 10 and 18 h after operation. Pain and side effects were evaluated at 2, 4, 8, 12 and 24 h after operation. In the extradural group, significantly smaller pain-scores were observed both at rest and during cough compared with the CSCI group. No significant difference was observed between the groups regarding supplementary doses of morphine, peak expiratory flow values or side effects. We conclude that morphine by CSCI is not as effective as morphine injected extradurally. However, CSCI seems to provide simple and relatively effective analgesia with a low rate of side effects.

Analgesia, Epidural↗
PubMed1993

Incidence, presenting features and prognosis of low-grade B-cell non-Hodgkin's lymphomas. Population-based data from a Danish lymphoma registry.

During the period January 1983 to January 1988 1597 newly diagnosed cases of non-Hodgkin's lymphoma (NHL) were included in a Western Danish population-based NHL registry. Of these, 31% (N = 496) were low-grade NHL (LG-NHL) consisting of (Kiel): 9% lymphocytic (LY), 27% lymphoplasmacytic/-cytoid (IC), 53% follicular centroblastic/-centrocytic (CB/CCf) and 11% unclassifiable low-grade. LG-NHL (age range: 26-94 yrs, median: 64 yrs; M/F ratio: 0.8) had an age-standardised incidence rate (IR) of 2.7/10(5)/yr. Age-specific IR's showed an age-related exponential rise in all subtypes except for CB/CCf. Compared with the intermediate (IG)- and high-grade (HG) group, LG-NHL had more female cases (M/F ratio: 0.79 vs. 1.2; p = 0.0002), a higher frequency of stage III-IV disease (66% vs. 53%; p < 0.00005) and of bone marrow involvement (39% vs. 19%; p < 0.00005). A later revision of all IC cases (N = 132) distinguished 79 non-polymorphic (ICnp) from 25 polymorphic (ICp) cases; 28 cases were differently classified. In 34 LG-NHL patients histologic transformation was verified: CB/CCf to CB diffuse (22 pts) and LY to immunoblastic or CB type (6 pts). The 7-yr survival for LG-NHL was 63% (IG: 48%, HG: 38%; p < 0.00005). A Cox-regression analysis identified the following adverse prognostic factors for survival in LG-NHL: age > 50 with a relative risk (RR) of 3.2, hepatic involvement (RR = 2.1), elevated s-LDH (RR = 1.9), B-symptoms (RR = 1.8) and IC histology (ICnp+ICp) (RR = 1.7).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Determination of vitamin b12 deficiency].

Development of cobalamin deficiency in the tissues is considered to be a process which lasts for years. Macrocytic anaemia and/or neurological symptoms do not occur until late in this process. Serum cobalamins as the only parameter have proved less suitable for differentiation between healthy individuals with low serum cobalamin values and patients who require cobalamin for the remainder of their lives. The need for a better indicator for cobalamin deficiency has been emphasized. Recently developed methods of measurement have rendered determinations of serum methylmalonic acid possible. This value is raised in cases of cobalamin deficiency in the tissues. The serum methylmalonic values have proved both sensitive and specific to determine the extent to which genuine cobalamin deficiency is present or not and may also be employed for monitoring the effect of treatment as the raised values becomes normalized following substitution therapy with vitamin B12.

Humans↗
PubMed1992

[Laboratory diagnosis of cobalamin deficiency. A comparative study of 2 serum cobalamin methods and serum methylmalonic acid].

The diagnosis of cobalamin deficiency is established traditionally by demonstration of lowered serum cobalamin, but, for many reasons it cannot be anticipated that the concentrations of cobalamins in the serum reflect the relationship between blood cobalamin and tissue cobalamin accurately. The blood methylmalonic acid which cannot be metabolized in cases of cellular cobalamin deficiency should, on the other hand, indicate the cobalamin available for the tissues. A blind, prospective, controlled investigation was undertaken to compare the clinical employability of a recently developed method for measurement of the concentration of methylmalonic acid in the serum with older and more recent methods of measuring serum cobalamins. The three methods classified 94, 72 and 74% of the patients correctly, respectively (n = 50). The results reveal that serum methylmalonic acid is a more sensitive and specific analysis for demonstrating whether cobalamin deficiency was present or not. Serum cobalamins measured by both methods are relatively insensitive and unspecific markers for cobalamin deficiency in the tissue. Low cobalamin concentrations do not indicate that the patient in question has cobalamin deficiency, and values in the lower half of the reference interval do not exclude cobalamin deficiency. Measurement of methylmalonic acid in the serum is recommended in patients with low-normal or low serum cobalamin.

Adolescent↗
PubMed1992

Serum methylmalonic acid before and after oral L-isoleucine loading in cobalamin-deficient patients.

Over a 1 1/2-year period, we measured concentrations of methylmalonic acid in serum before and after a standardized loading with oral L-isoleucine (100 mmol) in 13 patients admitted for evaluation of cobalamin deficiency. All patients had serum cobalamin values below 100 pmol l-1, but only 12 of the 13 patients were clinically confirmed cobalamin deficient. The clinically non-cobalamin-deficient patient had folate deficiency and was excluded. The serum methylmalonic acid concentrations before loading with isoleucine were above the upper reference limit (0.37 mumol l-1) in all the patients and L-isoleucine caused an increase in serum methylmalonic acid of more than 1.00 mumol l-1 in 11 of the 12 deficient patients. In the remaining patient the increase was 0.35 mumol l-1. The results show that a significant increase of an initially elevated serum methylmalonic acid concentration after isoleucine loading is a general finding in tissue cobalamin deficiency which strongly supports the diagnosis.

Administration, Oral↗
PubMed1992

Low level laser therapy for myofascial pain in the neck and shoulder girdle. A double-blind, cross-over study.

In a controlled, cross-over study the effect of low level laser therapy (LLLT) was evaluated. During a five weeks period forty-seven female laboratory technicians received six laser and six placebo treatments to tender points in the neck and shoulder girdle. Subjects rated the placebo treatment significantly more beneficial than LLLT (p = .04). There was no reduction in consumption of analgesics associated with either laser or placebo treatment. The results indicate no beneficial effect of LLLT for myofascial pain.

Adolescent↗
PubMed1991

[Malignant hematologic diseases. Diagnosis and treatment. A clearing report].

The malignant haematological disorders comprise the main groups leukemia, malignant lymphoma and multiple myeloma and the potentially malignant disorders: myelodysplastic syndrome, polycythaemia vera, myelofibrosis and M-component of uncertain significance. The common feature of all these disorders is monoclonality, i.e. they originate from one single cell. Around 2,000 new cases are diagnosed per year in Denmark. Because of the relative small number of patients, complex diagnosis and treatment (especially the possibility of cure on intensive treatment) a high degree of centralization is warranted to secure an evenly distributed high level of patient care and research. The present rules for referral of patients are unsatisfactory. A new referral system is proposed based on a common set of rules, agreed upon by five haematological centers in Denmark and the surrounding region, comprising diagnostic procedures, treatment, research and development for all haematological patients in the area. Based on these common rules (functional centralization) it is decided whether the individual patient can be treated in the primary hospital or should be referred to a center (geographical centralization). Recommendations about diagnosis, treatment and referral are made in this report. Detailed suggestions are given for diseases which may be treated locally whereas no detailed regimens are given for diseases and disease stages which should be centralized. In the latter cases, the main emphasis is placed on a presentation of treatment results.

Denmark↗
PubMed1991

Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Danish LYFO Study Group.

In a Danish population-based non-Hodgkin lymphoma (NHL) registry, 1257 newly diagnosed NHL cases were registered over a 5-year period. Of these, 463 (37%) were extranodal. The gastrointestinal tract was the most common site of extranodal involvement (30% of the cases). Histologically, 44% of all extranodal NHL cases had high-grade, 17% intermediate and 27% low-grade features, while 12% were unclassified. The most common histological subtype (Kiel) was the centroblastic diffuse (23% of cases). 50% of all extranodal NHL were localised (stage IE or IIE) and 27% had B symptoms. Site-specific features included a strong age-correlation for thyroid and testes lymphoma (greater than 50 years) and a high prevalence of female cases in thyroid and salivary glands lymphomas (M/F 0.14 and 0.30, respectively). Overall 7-year survival for extranodal NHL was 46% (median 4.9 years). Poor prognosis patients could be identified by the presence of one or more of the following presentation characteristics: age greater than 65 years, B symptoms, high-grade histology, disseminated disease, elevated s-IgA and hyperuricaemia. Relative risk values ranged from 2.1 for age and B symptoms to 1.7 for hyperuricaemia.

Adolescent↗
PubMed1990

The relationship between clinically confirmed cobalamin deficiency and serum methylmalonic acid.

Over a 1-year period, we examined 42 consecutive patients with low serum cobalamin levels detected by primary screening test (S-protein binder, RIA). In 31 patients (74%) clinical cobalamin deficiency was confirmed, whereas the remaining 11 patients (26%) were characterized clinically as non-cobalamin deficient. The serum methylmalonic acid level was higher than 0.34 mumol l-1 (3 SD above the mean in normal controls) in 30 of the 31 clinically characterized cobalamin-deficient subjects, and below this level in 10 of the 11 non-deficient patients. We conclude that the serum methylmalonic acid assay provides an appropriate means of discrimination between cobalamin deficiency and non-cobalamin deficiency (efficiency = 0.95), and we recommend that the assay be adopted as the standard test for diagnosis of tissue cobalamin deficiency.

Adult↗
PubMed1990

Effects of long-term coenzyme Q10 and captopril treatment on survival and functional capacity in rats with experimentally induced heart infarction.

The effects of coenzyme Q10 (CoQ) and captopril on functional capacity, hemodynamics and survival were studied in 154 rats that recovered after experimental myocardial infarction. Rats were randomized into four groups receiving either CoQ, captopril, a combination of the two drugs or 1 ml of tap water once daily for 12 weeks from the day of coronary artery ligation. CoQ as well as captopril and the combined treatment significantly improved exercise capacity as evaluated by lactate production during a standardized treadmill exercise test. No significant changes in heart rate or mean blood pressure were observed during the study in the captopril-treated group. CoQ treatment increased the maximum heart rate significantly, whereas no effect on mean blood pressure was observed. Both captopril and CoQ decreased pulmonary congestion. Furthermore, the data may suggest that captopril prevents right ventricular hypertrophy seen in placebo-treated rats with large infarcts. This was not observed after CoQ treatment. Captopril treatment improved 3-month probability of survival (93%) as compared with placebo (74%) (P less than .05). CoQ and the combined treatment tended to improve survival, but this was, however, not statistically significant.

Animals↗
PubMed1989

Differentiation between Bernard-Soulier syndrome and immune thrombocytopenia by immunostaining of peripheral blood.

Peripheral blood smears from seven patients with Bernard-Soulier syndrome were examined by an immunocytochemical staining procedure using a monoclonal antibody specific for platelet glycoprotein Ib. No platelet staining was observed except for very slight staining of the large sized platelets from one of the patients. Application of the assay to blood smears from 12 patients with immune thrombocytopenia showed that their peripheral platelets stained normally, so the assay can be used to differentiate between immune thrombocytopenia and Bernard-Soulier syndrome and to confirm a diagnosis of the syndrome.

Adolescent↗
PubMed1989

Studies on methylmalonic acid in humans. II. Relationship between concentrations in serum and urinary excretion, and the correlation between serum cobalamin and accumulation of methylmalonic acid.

Methylmalonic acid (MMA) concentrations are increased in cobalamin (vitamin B12) deficiency, but the relative diagnostic usefulness of determination of MMA in serum vs urine has not yet been assessed. We obtained urine collections and matched serum samples from 28 healthy volunteers and from 20 consecutive patients admitted for clinical and hematological evaluation because of low cobalamin concentrations in serum. Increased concentrations of MMA in serum were found in 12 patients, in all of whom a clinical diagnosis of cobalamin deficiency was established. By contrast, cobalamin deficiency was excluded in seven of the eight remaining patients, who all had normal MMA concentrations. Here we report that linear relationships exist between MMA concentrations in serum (investigated range: 0.05-34.2 mumol/L) and MMA concentrations in urine (r = 0.74), concentrations relative to creatinine (r = 0.98), and MMA excretion rates (r = 0.97) (P less than 0.001 in each instance). Our data are consistent with glomerular filtration and passive reabsorption of MMA by the tubules. We demonstrate, for the first time, a negative correlation between concentrations of cobalamin and MMA in serum in clinical cobalamin deficiency (r = -0.69; P less than 0.01; n = 12); when the values for MMA were log transformed, the correlation with cobalamin was much better (r = -0.84; P less than 0.0005).

Adult↗
PubMed1988

Recombinant interferon-alpha-2b treatment of hairy-cell leukaemia: experience with a low-dose schedule.

50 patients with hairy cell leukaemia (HCL) were treated with recombinant interferon (IFN) alpha-2b 2.0 x 10(6) IU/m2 subcutaneously three times weekly to evaluate the efficacy of low-dose IFN therapy in inducing and maintaining remission of the disease. At the time of this report 48 patients, of whom 22 were splenectomized, had been treated for at least 3 months and were considered evaluable for response. The median observation time on IFN-alpha-2b was 11 months (range 3 to 20). 4 cases with atypical disease (spongy lymphoid myelofibrosis) were also included. All patients responded to IFN. After 3 months 11/48 patients (23%) had achieved a partial remission (PR) with normalization of peripheral blood values. After 6 months 27/43 patients (63%) had achieved a favourable response; complete remission (CR) was recorded in 4 and PR in 23 patients. The proportion of patients with favourable responses (CR + PR) increased with the duration of therapy and after 12 months of therapy 23/28 (82%) patients showed CR or PR, 9 patients (32%) being in CR. Splenectomized patients disclosed a trend towards a more rapid response. It is concluded that IFN-alpha-2b is a highly effective first-line therapy for HCL.

Adult↗
PubMed1987

Terminal stage lymphoproliferative disorders treated with low dose cytosine arabinoside.

5 heavily pretreated patients with chronic lymphocytic leukaemia or non-Hodgkin lymphoma resistant to alkylating agents were treated with low-dose cytosine arabinoside (ARA-C). 3 of the patients showed a clinical and laboratory improvement lasting from 8 to more than 20 months. Low dose ARA-C may be therapeutically effective in terminal stages of lymphoproliferative disorders.

Adult↗
PubMed1986

Sclerosis and hyperostosis of the manubrium sterni.

Seven females and one male with almost identical sclerotic and hyperostotic changes of the manubrium sterni are reported. The clinical course was prolonged and characterized by intermittent periods of exacerbation followed by improvement. Malignancies, bacterial inflammatory processes, and Paget disease, which were first suspected, could be excluded. Pustulosis-palmoplantaris was present in four patients and one had psoriasis vulgaris. None of the patients had sacroiliitis or peripheral joint changes, but the three youngest patients had sclerotic changes of other bones, including the lumbar spine, the pubic bone, and the clavicle. This may indicate that this is an adult disease analogous to "chronic recurrent multifocal osteomyelitis", a disease mainly present in children and adolescents.

Adult↗